FAQ: When Should I Be Tested For Clotting Conditions?

After a blood clot, tests can be run to determine if you have a condition that makes your blood clot more easily than the majority of the population.  These conditions are often referred to as clotting conditions, thrombophilia, or hypercoagulable states.  Testing for these conditions will not be able to predict who will and will not have a clot.  About half of the people who have a clot will have no known cause.  This means that the blood work would show no clotting conditions.

Testing for thrombophilia is useful when deciding the length of time a patient will be on anticoagulants.  The problem with anticoagulants is that they are risky.  You only want to be on anticoagulants if the risk of clotting is larger than the risk of a life threatening bleed.  Testing for thrombophilia will give you more information so that you and your doctor can determine which risk is more acceptable for you.

To determine if thrombophilia testing is right for you, you should:

• Ask your doctor if having thrombophilia would change his or her recommendations about the amount of time that you will take anticoagulant medications.  If the test will not change treatment, the test is not needed.
• Talk with your doctor and insurance agents about the impact the findings may have on your ability to obtain life insurance.
• Consider your age.  Many recommendations state that individuals under the age of 50 that had a DVT or PE without a significantly large risk factor (abdominal surgery, bed ridden, cancer, or other major risks) have tests run to see what may have caused the clot.
• Consider your risks.  Can you and your doctor identify any MAJOR risks?  A major risk may be able to be eliminated so that the clot doesn't repeat.  If you only had a minor risk (weight and birth control are examples) there is a good chance that something else contributed to your clot.
• Ask your medical team what they feel are typical, minor, and major risks for blood clots and figure out where you fit into that list.
• Consider what risks will be in your future.  Are you thinking about birth control, infertility treatments, cancer, hormone replacement, frequent long haul airplane trips, or any other big risks?  You may want to know if you have a clotting condition that will put you at further risk.
• Is there a family history of clotting or miscarriage?  If there is, let your doctors know!
  

Think about your history, the costs, risks, and benefits.  Medical testing seems harmless but it can have unwanted effects.  If you need help deciding about testing please talk to your primary care provider and consider requesting a hematology consult.  Feel free to get a second opinion.  Many times doctors will write off a clot as a simple case of birth control pills, weight, or travel when there might be more to the story.  If you haven't experienced a recent major risk factor there is a good chance that there is more to your clot's story.